CARDIAC TRANSPLANT -A SINGLE CENTRE RETROSPECTIVE OBSERVATION

Abstract

Background and Aim: Advances in pharmacological and nonpharmacological management of heart failure shifted the paradigm to transplantation of heart. Currently so many centers are doing heart transplant as the availability of donors and recipients are increasing day by day. The goal of this study is to share our experience in all our heart transplantation procedures. Ours is a tertiary care government multi super Speciality hospital. In our institute we have been doing cardiac surgeries for six years and heart transplants for past three years. In this discussion we share our experience about how we did all the procedures in our center . Method: After getting approval from institutional research committee we analyzed 8 transplants done in our center. The preoperative optimization, monitoring tools, anesthetic technique and post-operative complications and management are discussed . Apart from routine monitors we have used BIS, Cerebral oximetry and cardiac output monitors. Result: Of the eight cases, six are doing well including a (pediatric) 10-year-old recipient. Of the remaining two, one patient died on 3rd Post-Operative Day due to acute kidney injury and the other was death due to acute rejection. Conclusion: The key points we have learnt from our experience are careful selection and preparation of the donor, adequate preload with optimal inotropic support during weaning, minimizing increase in pulmonary vascular resistance and good pain relief are key aspects for successful outcome.